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Cyperus Rotundus in the Management of Metabolic Syndrome

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Cyperus Rotundus in the Management of Metabolic Syndrome Pandey et al RJLBPCS 2021 www.rjlbpcs.com Life Science Informatics Publications Original Review Article DOI: 10.26479/2021.0703.03 CYPERUS ROTUNDUS IN THE MANAGEMENT OF METABOLIC SYNDROME – BENEFIT IN THE TREATMENT OF METABOLIC SYNDROME Nikhil Pandey, Priyanka Mishra, Yamini Bhusan Tripathi* Department of Medicinal Chemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India. ABSTRACT: Cyperus rotundus, (Cyperaceae), commonly known as Nagarmotha (H) and Nutgrass (E). Its pharmacological claims are anti-inflammatory, anti-pyretic, diuretic, wound healing property, post-parturition use and other reproductive disorders in females. Charak Samhita is grouped under “lekhniya dravya”, a group of medicinal plants acclaimed to clean the channels, by removing fat deposits and body weight-reducing effects. Here, we have reviewed its pharmacological and phytochemical properties by using keywords like metabolic syndrome (MetS), Hyperglycemia, Hyperlipidemia, Anti-oxidant, Anti-inflammation, Type II diabetes, Obesity, Blood pressure, Fatty liver and Atherosclerosis in the PubMed and Web of sciences. Result- We found 250 articles in PubMed and 226 in the web of sciences. The duplicates were excluded by using Mendeley software, and finally 23 papers were reviewed for experimental data. Conclusion- We found that Cyperus rotundus is effective in the management of MetS in clinical studies and experimental models. Some papers have highlighted the mechanistic approach of its phytoconstituents concerning various diseases of MetS, which is mainly through its anti-inflammatory and antioxidant potentials. Keywords: Metabolic Syndrome, Cyperus rotundus, Phytoconstituents, Signaling pathways, Food Supplement. Article History: Received: May 14, 2021; Revised: June 08, 2021; Accepted: June 22, 2021. Corresponding Author: Dr. Yamini Bhusan Tripathi* Ph.D. Department of Medicinal Chemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India. Email Address: [email protected] © 2021 Life Science Informatics Publication All rights reserved Peer review under responsibility of Life Science Informatics Publications 2021 May – June RJLBPCS 7(3) Page No.18 Pandey et al RJLBPCS 2021 www.rjlbpcs.com Life Science Informatics Publications 1.INTRODUCTION Metabolic syndrome (MetS) is a cluster of obesity, elevated blood pressure (BP), blood sugar, and atherosclerosis. It is distinguished by a collection of interconnected atherogenic risk factors including oxidative stress (OS), dyslipidemia, hypertension, diabetes, obesity, insulin resistance (IR), and lifestyle factors such as dietary patterns and physical inactivity. Hyperglycemia and hyperlipidemia are the primary causes resulting in hypertension and atherosclerosis. Abnormal level of inflammatory cytokines, reactive oxygen species, dysregulated lipid metabolism and insulin resistance are interconnected to the syndrome. Various medical agencies such as International Diabetes Federation, National Cholesterol Education Program’s Adult Treatment Panel III, and the WHO have suggested definition for metabolic syndrome but all concentrate on five medical conditions as a diagnosis guideline which includes following key point: Box 1-Key criteria that constitutes MetS • Waist Circumference- >35 inches or 88.9 cm (F)/ >40 inches or 101.6 cm (M) • Fasting glucose =/> 100 mg/dL • Triglycerides =/> 150 mg/dL • High density lipoproteins (HDL) < 50mg/dL (F)/ <40mg/dL (M) • Systolic blood pressure =/> 130 mmHg • Diastolic blood pressure =/> 85 mmHg Genetic predisposition, lifestyle and environmental factors are responsible for the manifestation of MetS. It is considered as “lifestyle-related non-communicable chronic diseases” (NCDs) so its prevention from an early age is recommended. The basic cause behind the manifestation of all the diseases of MetS appears to chronic inflammation, insulin resistance, and visceral obesity. These results in the creation of abnormal adipocyte with M-1 macrophage infiltration and abnormal secretion of adipokines e.g., adiponectin and leptin enhanced release of inflammatory cytokines including IL-1, IL-6, TNF-α, excess free radical generation associated with mitochondrial dysfunction and endoplasmic reticulum (ER) stress. The treatment strategies for MetS focus on lifestyle modification along with pharmacological interventions, but they are not enough. Most of the time they are also associated with several adverse effects, resulting in poor compliance in patients [1]. Thus, several new types of research are going on to develop specific food supplements and herbal medicines for its management with better compliance and acceptability. Efforts are also being made to understand the molecular mechanism behind the recommendations for changing the lifestyle and food habits in scientific terms for their acceptance by the educated and well-informed consumers. Here recommendations of complementary medicine of different countries are being explored. In India, © 2021 Life Science Informatics Publication All rights reserved Peer review under responsibility of Life Science Informatics Publications 2021 May – June RJLBPCS 7(3) Page No.19 Pandey et al RJLBPCS 2021 www.rjlbpcs.com Life Science Informatics Publications the AYUSH system of health care includes Ayurveda, yoga, and Unani, Siddha and Homeopathy. They have their own Materia-medica with a specific way of diagnosis and treatments. In addition, ‘Swaripa’ a Tibetan medicine and naturopathy are also in practice. These systems include medicines, derived from plants, minerals and biological products, but in Ayurveda, Maharishi Charak has described three approaches of treatments. These are spiritual healing (Devavyapasharya), Psychological counselling (Satwavajaya) and medicines (Youkti Vyapasharya). He has emphasized more regulate the quality, amount and time of feeding, customized to a person, based on their body and mind constitution (Prakriti), season and age indicating towards personalized medication [2]. The goals of therapy are to treat the underlying cause of the syndrome, reduce morbidity, and prevent complications, including premature death. Many efforts have been made over the last decade to employ natural products in drug development. More than two-thirds of the active agents of drugs have a relationship to natural sources. Among 19 natural-based drugs that have been approved for worldwide marketing between the years 2005–2010, 7 have been classified as natural products, 10 as semi-synthetic natural products, and 2 as natural product-derived drugs [3]. Some examples include Veregen ™ as a mixture of catechins derived from green tea against genital warts, Sativex® derived from Cannabis plant for pain relief, and Exenatide (Byetta®) isolated from Heloderma suspectum as adjunctive therapy in type 2 diabetes [4]. In this review, the application of Cyperus rotundus (Indian nagarmotha) on reported pathways relating to MetS has been briefly discussed. It is one of the 10 plants of lekhan Dravya. All plants of this group are listed (Table-A) The Cyperus rotundus L. (Nut Grass), is a common perennial weed having a long list of pharmacological claims, (Table- B) This review attempts to sum up the application of Indian nagarmotha or Cyperus Rotundus (CR) in the management of MetS by depicting the probable role of the plant as a whole or the reported active phytoconstituents on the mechanistic pathway leading to the development of this syndrome. Their mechanism of action can either be by blocking the key receptor or manipulating the key signaling molecule in the pathways of pathogenesis. We have searched the literature using PubMed, and Web of Science’s database with the keywords Cyperus rotundus, metabolic syndrome (MetS) Anti- inflammation Anti-oxidant, Hyperlipidemia, hyperglycemia, atherosclerosis, Blood pressure, Type II diabetes, Obesity, and their mode of action on metabolic pathways, for the inclusion of papers in order to prepare this review article. The references list of all the articles were searched manually to obtain relevant and additional information and analysis of experimental data and common parameters about the experiments. © 2021 Life Science Informatics Publication All rights reserved Peer review under responsibility of Life Science Informatics Publications 2021 May – June RJLBPCS 7(3) Page No.20 Pandey et al RJLBPCS 2021 www.rjlbpcs.com Life Science Informatics Publications Results: For our studies, we selected 23 papers out of 476 results with PubMed (250) and Web of Sciences (226) based on the mentioned keywords with (Fig 1). Further, these were processed by using Mendeley software to screen out duplications and a total of 160 were screened out. After that from these 160, we included those papers where studies carried on the animal model (i.e., Rats and Mice) and in vivo. Next, we considered only those studies which had “Cyperus rotundus’’ and not in combination with any other plant. Based on various studies (in-vivo and in vitro), reported earlier, we concluded that CR in any form, be it an extract or isolated phytoconstituents has shown its efficacy on animal models, as well as in cell cultures significant in terms of, anti-oxidant anti-inflammatory effect, Hypolipidemic activity, Anti-obesity, Type II diabetes and also in Cardiovascular Disorders such as atherogenesis. Therefore, from analysis of experimental data from above-selected papers, it could be suggested that CR is showing significant changes in anti-oxidant, anti-inflammatory, Hyperlipidemia /Obesity/
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